This form is to be confidentially maintained in accordance with the Family Educational Rights and Privacy Act, 20 U.S.C. § 1232g.
Instructions: Upon receipt of MCPS Form 230-35, Bullying, Harassment, or Intimidation Reporting Form, the school principal/designee must promptly investigate (within two school days after receipt) the incident and document the investigation by completing this form. Complete one form for each alleged student victim. The school principal/designee will contact the parents/guardians of all students involved in the incident of bullying, harassment, or intimidation within 24 hours of completing the investigation. (Board Policy JHF, Bullying, Harassment, or Intimidation and MCPS Regulation JHF-RA, Bullying, Harassment, or Intimidation).
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